This application claims benefit of Japanese Application No. 2001-315750 filed in Japan on Oct. 12, 2001, the contents of which are incorporated by this reference.
1. Field of the Invention
The present invention relates to an endoscope system used in the diagnosis and treatment of diseases of the gastrointestinal or pancreatobiliary duct systems, and to a medical treatment method.
2. Description of the Related Art
The use of endoscopic treatments has recently been increasing for some diseases occurring in the gastrointestinal or pancreatobiliary duct systems.
For example, endoscope systems used for the abovementioned pancreatobiliary duct systems include diagnostic procedures for contrast imaging of biliary or pancreatic ducts using an endoscope, as well as treatments and the like for retrieving gallstones that exist in the common bile duct and elsewhere by means of a balloon or gripping implement passed through the treatment instrument threading channel of an endoscopic treatment system.
These treatments are performed in the pancreatic duct, bile duct, hepatic duct, and the like usually by passing the end of an endoscope insertion portion up to the vicinity of the duodenal papilla, and then selectively inserting a catheter or similar treatment instrument passed through the endoscope treatment instrument threading channel into the pancreatic duct, bile duct, or hepatic duct with a guidewire under X-ray illumination.
The abovementioned guidewire used in the pancreatobiliary duct system may be about 400 cm in length.
In U.S. Pat. No. 5,921,971, a bile duct catheter is proposed for facilitating exchanging of a treatment instrument.
The bile duct catheter according to U.S. Pat. No. 5,921,971 extends an opening in a longitudinal direction between the distal and proximal sections of the guidewire lumen in the catheter shaft.
Specifically, the bile duct catheter having a firfixening at the front end of the guidewire lumen, and a second opening communicated with the first opening on the proximal side, and a treatment instrument for which the guidewire is used as a guide inserts and removes in a state in which the guidewire is fixed by being held down when extended from a slit.
Endoscope systems in which a mini-scope, ultrasound probe, or the like is threaded from the treatment instrument threading channel to perform observation and treatment are also used on an increasing scale, primarily in cases involving the pancreatobiliary system.
In such cases, the endoscope systems are operated such that a mini-scope, ultrasound probe, or other component threaded through the treatment instrument threading channel is elevated toward the desired affected area with the aid of a treatment instrument elevator fitted to the distal section of the endoscope insertion portion.
An endoscope system featuring the catheter thus configured requires that the following two operations performs exchanging of the treatment instrument when the treatment instrument is exchanged in a situation in which, for example, the tip of the guidewire is inserted into the duodenal papilla, by inserting the guidewire to the same degree of travel while the treatment instrument is withdrawn from the treatment instrument threading channel of the endoscope, or by withdrawing the guidewire to the same degree of travel in the same manner while the treatment instrument is inserted into the treatment instrument threading channel.
An endoscope system comprising a treatment instrument elevator in which a guidewire fixing slit is formed on the apex of the guide surface thereof is proposed in Japanese Patent Application Laid-open No. 2002-34905. The guidewire is usually rigid; but because of the length thereof, the distal end of the guidewire protruding from the treatment instrument threading channel does not necessarily extend straight out from the treatment instrument threading channel.
It is desirable if there were an endoscope system which can facilitate the exchanging of a treatment instrument.
According to a first aspect of the present invention, an endoscope system comprises an endoscope main body, a first fixing member, a second fixing member and a tubular member. The endoscope main body has an insertion portion in which a lumen is formed and the insertion portion has a proximal end and a distal end. A distal end opening of the lumen is provided to the distal end of the insertion portion and a proximal end opening of the lumen is provided to the proximal end of the insertion portion. The first fixing member provided to the distal end of the insertion portion is capable of selecting between a fixed state for fixing the distal end portion of a linear member inserted into the lumen and a released state thereof in the distal end portion of the insertion portion. The second fixing member provided to the proximal end of the insertion portion is capable of selectively fixing the proximal end portion of the linear member inserted into the lumen in the proximal end of the insertion portion. And the tubular member has a proximal end, a distal end, and is a lumen running therebetween, and is removably inserted into the lumen. A slit is formed from the proximal end of the tubular member towards the distal end thereof.
According to a second aspect of the present invention, a medical treatment method comprises the following steps. The method includes a step for inserting a first treatment instrument into the lumen of the endoscope insertion portion and placing the distal end of the first treatment instrument in the body cavity. The method further includes a step for placing a guidewire in the lumen of the first treatment instrument, a step for pulling the proximal end portion of the guidewire diametrically from the lumen of the first treatment instrument after the distal end of the guidewire inserted into the first treatment instrument is placed in the body cavity, and a step for fixing the portion of the proximal end of the guidewire pulled from the first treatment instrument at the proximal end of the endoscope lumen, and a step for pulling the first-treatment instrument towards the proximal end of the insertion portion. The method further includes a step for fixing the distal end portion of the guidewire at the distal end of the endoscope insertion portion after the distal end of the first treatment instrument is positioned within the insertion portion of the endoscope, a step for releasing the fixing of the guidewire in the proximal end of the endoscope insertion portion, and a step for pulling the first treatment instrument from the proximal end opening of the endoscope insertion portion.
Other characteristics and merits of the present invention will be made adequately clear by the following description.